Residential and School Food Swamps and Overweight in Children and Adolescents: A Cross-Sectional Analysis in Urban Brazil.

The community food environment, which encompasses residential and school neighborhoods, is an important determinant of overweight in children and adolescents. This study aimed to investigate the relationship between the co-occurrence of food swamps in residential and school environments and overweight status. This cross-sectional study included 2601 children and adolescents (aged 5-14 years) from 47 schools in a medium-sized municipality in Brazil. The outcome was overweight status, defined as body mass index for age exceeding the mean by at least one z-score. Food swamps in residential and school surroundings were defined as buffers of 250 m with four or more establishments selling ultra-processed foods. The prevalence of being overweight was 30.4%. Food swamps were present in 22.5% and 22% of the residential and school areas, respectively, and 16.2% of the participants were exposed to food swamps in both residential and school environments. Children and adolescents simultaneously exposed to food swamps in both residential and school areas had a higher likelihood of being overweight (odds ratio: 1.22; 95% confidence interval: 1.02-1.45). The simultaneous presence of food swamps in residential and school environments is associated with overweight in children and adolescents.